CJIC Abstracts & Online Journal

This section features abstracts of scientific articles that have been published in the Canadian Journal of Infection Control prior to 2005, as well as online journals from 2005 to the present. Click here to find out more about the Journal.

CJIC Abstracts

The following are abstracts from journals prior to 2005:

Volume 19, Number 4 (Winter 2004) [abstracts not available]"Improving quality of service in a sterile processing and operating room setting"
"Surgical site infections: An obvious target for quality improvement and patient safety initiatives"
"CHICA-Canada® Position Statement: Perioperative Antibiotic Prophylaxis for the Prevention of Surgical Site Infection"

Volume 18, Number 4 (Winter 2003 [abstracts not available]"The state of infection surveillance and control in Canadian acute care hospitals"
"The Community Clergy and SARS: An educational opportunity"
"Infection Control and the OR Flash sterilization (steam)"
"Results of the 2003 CHICA-Canada® Membership Survey"

Volume 18, Number 3 (Fall 2003) [abstracts not available]"Incidence of nosocomial infections in a Canadian adult intensive care unit"
"Hospital planning for bioterrorism: are you prepared?"

Volume 18, Number 2 (Summer 2003)No abstracts in this volume. Special reports on SARS.

Volume 18, Number 1 (Spring 2003) [abstracts not available]"Alcohol hand sanitizers: an examination of the evidence of their efficacy"
"Teaching infection control through WebCT, across Canada and beyond"
"Construction issues and the ICP"

West Nile virus is an emerging infectious disease in Canada, first detected in birds and moxquitoes in southern Ontario in 2001. This review article summarizes current information regarding the natural history and epidemiology of West Nile virus both worldwide and in Canada. Surveillance methods and preventive measures are discussed, with an emphasis on what is currently implemented in Canada.
Two years after the first reported human cases of West Nile Virus infection in humans, there is no clear indication of the magnitude of effect on public health in Canada. However, there are practical measures that individuals can use to minimize the risk of infection, especially those at high risk of infection or those more likely to experience more severe health outcomes. This information should be available from family physicians and public health units.

"Practice analysis for infection control and epidemiology in the new millenium"
Volume 17, Number 4 (Winter 2002)

Background: The Certification Board of Infection Control and Epidemiology appointed an advisory committee to conduct a practice analysis (PA) of infection control professionals (ICPs) to identify current practices of ICPs. Results of the PA would assist in the development of a revised certification examination.Methods: Five thousand seven hundred fifty-three questionnaires were distributed to ICPs in the United States and in Canada, as well as to a subsample of ICPs in other countries. Decision rules and criteria were applied to each identified task in the PA.Results: A total of 1306 responses were available for analysis, for a 24% return rate. The majority of the respondents were certified in infection control, had a background as a registered nurse, and worked in a community hospital with 200 or fewer beds. Six major categories, with 135 tasks, were identified in the PA. The following two new categories were included: education and research and infection control aspects of employee health.Conclusions: The PA reflects current changes in the practice of infection prevention/control and applied epidemiology in the United States and Canada. The test specifications accepted for adoption by the Certification Board of Infection Control and Epidemiology will be used to build all examination forms for a certification program for ICPs.

"Lessons from the past: Tuberculosis nursing in British Columbia 1895-1945"
Volume 17, Number 2 (Summer 2002)

In 1895, tuberculosis (TB) was epidemic world-wide, and the leading cause of death in British Columbia and Canada; in 1945, streptomycin was introduced as the "magic bullet" that, for several decades, conquered the disease. Although there was no effective cure, mortality rates in B.C. dropped from approximately 200 per 100,000 population to 55 per 1000,000 population during those 50 years. This remarkable drop occurred mainly because of infection control education carried out by health professionals with patients and families both within hospitals and in the community. Initially, most teaching was done by nurses hired by lay associations and volunteer agencies, and later through the newly established public health departments through public education campaigns. Unfortunately many nurses in hospitals, especially student nurses, became victims of the disease, mainly because they received poor education about infection control and because of poor practice in hospitals. This historical research article, drawing on primary and secondary documents, provides an overview of nursing's involvement that helped bring about the decline of TB in both the general population and, finally, among nurses themselves. Although this research focuses on a period more than 50 years ago, with the resurgence of TB world-wide today, there may be lessons to be learned from the past.

Every year in British Columbia, many Residential Care Facilities (RCF) experience outbreaks of gastroenteritis affecting both residents and staff. These outbreaks have a significant affect on the residents' quality of life and the staff's ability to provide care. Based on clinical signs and symptoms, most of the outbreaks are viral in origin. British Columbia Centre for Disease Control (BCCDC) coordinated 45 outbreaks (defined as three or more cases of gastroenteritis within a four day period) between January 1 and April 30, 2001. The majority of the outbreaks occurred in RCF. In response to this 88% increase over the previous year and requests from the field for an infection control procedure for controlling these outbreaks, BCCDC developed a guideline titled Managing Outbreaks of Gastroenteritis in Residential Care Facilities. This guideline was adapted from existing protocols developed by the Vancouver and Simon Fraser Health Regions.

The purpose of this Infection Control survey was to evaluate the recommendations from the BCCDC guideline. Characteristics of facilities that experienced outbreaks during this period and measures used to control outbreaks were evaluated and linkages with Antibiotic Resistant Organisms explored. Information was gathered through a mailed out/telephoned survey from 57 RCF in the province. Facilities that experienced gastroenteritis outbreaks were matched with similar control facilities that did not. Thirty-five (65%) of the surveys were completed. no significant differences were seen in outbreak vs. non-outbreak facilities although some interesting trends were observed. Results provide some insight into characteristics of residential care facilities that may lead to outbreaks of gastroenteritis and effectiveness of the infection control measures used to control those outbreaks.

Objective: To examine the success rate of mupirocin/chlorhexidine therapy (M/CT) in a group of hospitalised patients colonized with methicillin-resistant Staphylococcus aureus (MRSA).Design: A retrospective analysis based upon a chart review of 146 patients identified as MRSA positive decolonized and tested post treatment between January 1992 and October 1996.Setting: A 500-bed adult tertiary care hospital in London, Ontario, Canada.Results: Two of 32 patients (6.25%) treated only with vancomycin were culture negative on follow-up screening. This compares to a 35.4% success rate (42/114) for those who received M/CT with or without vancomycin (p=0.003). Medical patients achieved a higher eradication rate than those persons on a surgical service, 51.1% vs. 24.3% (p=0.01). Those successfully decolonized had a survival rate of 95.1% compared to 73.3% for those not successfully decolonized (p=0.002). Very few of the total population (<4%) were MRSA positive only at an extra-respiratory site prior to or following decolonization.Conclusions: The success rate for decolonization of hospitalised MRSA positive persons is poor, and therefore, this strategy should be limited to certain, well-defined subgroups within this population of patients.

Objective: To provide a rapid and efficient means to collect descriptive epidemiologic data on occurrences of vancomycin-resistant enterococci (VRE) in Canada.Design and Methods: Passive reporting of data on individual or cluster occurrences of VRE using a one page surveillance form.Setting: Periodic distribution to all Canadian Hospital Epidemiology members (CHEC), Infection Prevention and Control Canada (IPAC) members, l'Association des Professionnels pour la Prevention des Infections (APPI) members and provincial laboratories, representing 650 health care facilities across Canada.Patients: Patients colonized or infected with vancomycin-resistant enterococci within Canadian Health care facilities.Results: Until the end of 1998, 263 reports of VRE were received from 113 health care facilities in 10 provinces representing a total of 1,315 cases of VRE with 1,246 colonized (94.7%), 61 infected (4.6%) and 8 (0.6%) of unknown status. VRE occurrences were reported in 56% of acute care teaching facilities and in 38% of acute care community facilities. All facilities >800 beds reported VRE compared to only 10% of facilities with <200 beds (r=0.86). Medical and surgical wards accounted for 51.4% of the reported VRE. Sixty-five (24.7%) reportws indicated an index case was from a foreign country, with 85.2% from the United States and 14.8% from other countries. Some type of screening was conducted in 50% of the sites.Conclusions: A VRE passive reporting network provided a rapid and efficient means to provide data on the evolving epidemiology of VRE in Canada.

"Development of a resource model for infection prevention and control programs in acute, long term, and home care settings: Conference Proceedings of the infection Prevention and Control Alliance"
Volume 16, Number 2 (Summer 2001)

There is mounting concern about the impact of health care restructuring on the provision of infection prevention services across the health care continuum. In response to this, Health Canada hosted two meetings of Canadian infection control experts to develop a model upon which the resources required to support an effectivek, integrated infection prevention and control program across the health care continuum could be based. The final models project the IPCP needs as tghree full time equivalent infection control professionals/500 beds in acute care hospitals and one full time equivalent infection control professional/150-250 beds in long term care facilities. Non human resource requirements are also described for acute, long term, community and home care settings.

A medical surgical intensive care unit liver transplant patient in a tertiary care teaching hospital developed a nosocomial Aspergillus wound infection. The appearance of the infection suggested airborne contamination with the fungi. An investigation was conducted to determine the probable environmental source of Aspergillus fumigatus that resulted in the infection. Environmental surface sampling led to the isolation of Penicillium species, Dematiaceous mould and other saprophytic moulds from the overhead bed monitor, Aspergillus species, Aspergillus niger, Penicillium species, and Dematiaceous mould from a ceiling exhaust grill, Penicillium species and saprophytic mould from a curtain rod and sprinkler, and Aspergillus species, Penicillium species, and Paecilomyces species from a ceiling drop space in the patient's room. It was believed that the patient's wound became contaminated via fungal spores that filtered through the perforated metal ceiling tiles and the exhaust grill of the ceiling plenum due to air pressure differentials in the room. To address the problem: Housekeeping was increased, and wet method dusting was practised, dust containment for all construction activities was increased, and changes in design of the ventilation system were recommended: constant air volume supply, and smooth non-perforated ceiling surfaces. To conclude, hospital design of space and ventilation systems can be key in helping to control nosocomial infections.